Factors influencing the use of evidence based practice among physiotherapists and occupational therapists in their clinical work

Background: Evidence-based practice (EBP) is a process through which research is applied in daily clinical practice. Occupational therapists (OTs) and physiotherapists (PTs) are expected to work in line with EBP in order to optimise health care resources. This expectation is too seldom fulfilled. Consequently, research findings may not be implemented in clinical practice in a timely manner, or at all. To remedy this situation, additional knowledge is needed regarding what factors influence the process of EBP among practitioners. The purpose of the present study was to identify factors that influence the use of EBP and the experienced effects of the use of EBP among PTs and OTs in their clinical work. Method: This was a qualitative interview study that consisted of six group interviews involving either OTs or PTs employed by the Jönköping County Council in the South of Sweden. Resulting data were analysed using content analysis. Results: The analysis resulted in the following categories: “definition of evidence and EBP”, “sources of evidence”, “barriers to acquiring evidence and to using evidence in clinical work”, “factors that facilitate the acquisition of evidence and the use of evidence in clinical work”, and “personal experiences of using EBP”. Basing clinical practice on scientific evidence evoked positive experiences, although an ambivalent view towards acting on clinical experience was evident. Participants reported that time for and increased knowledge about searching for, evaluating, and implementing EBP were needed. Conclusion: Because OTs are more oriented towards professional theories and models, and PTs are more focused on randomised controlled trials of interventions, different strategies appear to be needed to increase EBP in these two professions. Management support was considered vital to the implementation of EBP. However, the personal obligation to work in line with EBP must also be emphasised; the participants apparently underestimate its importance.

Social media bodies : revealing the entanglement of sexual well-being, mental health, and social media in education

While media and youth research reveal the intersectionality of young people’s sexual well-being, mental health, and social media practices, little attention has been paid to how this entanglement is addressed in education. Pedagogy that is not informed by a nuanced and interconnected understanding of young people’s everyday experiences of sexual well-being, mental health, and social media is likely to be ineffective and inadequate. I describe a workshop activity with young people experiencing mental ill health that uses bodies as a metaphor for social media, allowing participants to reveal and discuss their experiences, attitudes, and values through dressing up and illustrating “social media bodies.” I outline three themes that arose from the workshops: revealing and destabilising affordances, the spatial and temporal affordances of social media, and young people’s affective relationships through and with social media, and advocate for an intersectional approach to sexuality education, one that is necessarily complex and ambivalent.

A magic pill? A qualitative analysis of patients' views on the role of antidepressant therapy in inflammatory bowel disease (IBD).

BACKGROUND: Studies with healthy volunteers have demonstrated that antidepressants can improve immunoregulatory activity and thus they may have a potential to positively impact the disease course in inflammatory bowel disease (IBD), a chronic and incurable condition. However, patients' views on the role of antidepressants in the management of their IBD are unknown. Thus, this study aimed to explore patients' experiences and opinions regarding the effect of antidepressants on IBD course before possibly undertaking future treatment trials with antidepressants. METHODS: Semi-structured in-depth interviews with open-ended questions were conducted with a randomly selected sample of IBD patients recruited at the Australian public hospital IBD clinic and currently receiving antidepressants. A qualitative content analysis was undertaken to summarise patients' responses. A Visual Analogue Scale was used to provide a quantitative assessment of patients' experiences with antidepressants. RESULTS: Overall, 15 IBD sufferers currently on antidepressants (nine females, six males) were interviewed. All 15 reported a positive response to antidepressants reporting they improved their quality of life, with minimal side-effects. Five patients (33.3%) felt the antidepressant had specifically improved their IBD course. Three patients noted how they believed the reduction in feelings of stress mediated the positive influence of the antidepressant on IBD course. Ten patients (66.7%) felt the antidepressants had not specifically influenced their IBD. Nine patients (60.0%) had a generally positive attitude towards antidepressants, four patients (26.7%) were ambivalent, and two patients (13.3%) held a negative view towards antidepressants. Twelve patients (80.0%) stated that they would be willing to participate in clinical trials. CONCLUSIONS: Antidepressants seem to be well tolerated by IBD patients. One third of patients reported an observable improvement of their IBD under the influence of this treatment. The positive attitude towards antidepressants in these participants may make the conduct of clinical trials to further assess for any specific role on IBD course feasible. However, due to a small sample size, a qualitative nature of this study and in light of the results of studies on other populations indicating reluctance to taking antidepressants at least in some patients, these results should be interpreted with caution until confirmed in quantitative studies.

‘Much more than a basic education’: supporting self-determination and cultural integrity in a non-traditional school for Indigenous girls

This paper presents data from an interview-based case study of a secondary school located in a suburban area of Queensland (Australia). The school is a non-traditional education site designed to support disadvantaged girls, many of whom are Indigenous, and is highly regarded for its holistic approach to gender and cultural inclusion and equity. Through lenses that align Nancy Fraser's theories of redistributive and recognitive justice, with Indigenous feminists' equity priorities, the paper identifies and analyses the structures and practices at the school that support the girls' capacities for self-determination and their sense of cultural integrity. The paper is an important counterpoint within the context of mainstream gender equity and schooling discourses that continue to homogenise gender categories, sideline the multiple axes of differentiation that interplay to compound gender (dis)advantage and deflect attention away from marginalised girls. In particular, it provides significant insight into how schools can begin to reconcile the double bind of racism and sexism that continues to stymie the schooling and post-school outcomes of Indigenous girls.

Geschlechtersonderwissen von Expert_innen für Inter*- und Trans*themen

Anhand von Expert_inneninterviews mit Aktivist_innen und Therapeut_innen aus dem Inter*- und Trans*bereich wird herausgestellt, wie Expert_innen Geschlecht thematisieren und auf welche Wissensformen sie hierfür Bezug nehmen. Professionssoziologische und gender- und queertheoretische Überlegungen werden in dieser wissenssoziologischen Untersuchung miteinander verknüpft, um Expert_innen des Geschlechts zu definieren und die im Rahmen der teilnehmenden Beobachtung erfassten Veränderungen im Diskurs um Inter*- und Trans*personen zu kontextualisieren. Dabei wird herausgestellt, dass zwar alternatives Wissen von Professionsangehörigen nicht mehr ausgeschlossen wird eine Deprofessionalisierung im Inter*- und Trans*bereich allerdings unwahrscheinlich erscheint. Vielmehr wird eine binäre Konstruktion von Expert_innen insbesondere von Professionsangehörigen reproduziert. Hierbei wird differenziert in professionsangehörige Expert_innen und Aktivist_innen, wobei erstere sich für gesellschaftliche Werte einsetzten würden und Aktivist_innen sich lediglich im Eigeninteresse handeln würden. Zur Einbettung und Erklärung der empirischen Erkenntnisse wird sich auf gender- und queertheoretische, psychoanalytische, diskurstheoretische, phänomenologische und emotionssoziologische Ansätze bezogen. Darüber wird die Fragilität der Kategorien Expert_in und Geschlecht und die Notwendigkeit der Anerkennung dieser für die eigene Handlungsfähigkeit verdeutlicht, ebenso wie die (Gefühls)Arbeit, die Expert_innen des Geschlechts alltäglich leisten müssen, um als Expert_in oder/und Inter*- oder Trans*person anerkannt zu werden. Grundsätzlich wird von Expert_innen des Geschlechts dem inkorporierten Wissen ein stärkeres Gewicht beigemessen als noch vor zehn Jahren, so das Fazit der Studie. Die Fokussierung auf inkorporiertes Wissen wird, anders als im bisherigen (Forschungs)Diskurs um Inter*- und Trans*personen allerdings in seiner Ambivalenz gesehen, da sie neben der Anerkennung alternativer Wissensformen auch zu einer Unmöglichkeit der Infragestellung dieses Wissens führen könne.

África Austral: Los minerales como recurso estratégico para los intereses de Estados Unidos y China, período 2000-2010

La región de África Austral emerge como un nuevo escenario geopolítico complejo, en el que la lucha por la adquisición de los derechos de exploración, extracción y distribución de minerales estratégicos ha intensificado la presencia del número de actores estratégicos en esta zona. En este sentido, es interesante analizar el juego de poder que se desarrolla entre Estados Unidos y China con el fin de neutralizar la debilidad estratégica que representa la carencia de estos recursos naturales, esenciales para el desarrollo de sus industrias, así como también la oportunidad que representan como mecanismo para ampliar las esferas de influencia extra continental. Así pues, la presente investigación analiza a partir de la explotación de los minerales como recursos estratégicos, los efectos de la geoestrategia reciente de estos dos jugadores activos del sistema internacional contemporáneo en la relación con los Estados que conforman la región meridional del continente africano, durante el periodo 2000-2010.

the health and well-being of nursing students in clinical practice . what prevents it? what promotes it?

Introduction: The training of nursing students in the context of clinical practice, is characterized by educational experiences, subject to various emotional stress (stress, ambivalence, frustration, conflict), sometimes making it very vulnerable student.However not all students use the same strategies minimizing their meanings and negative effects on the level of your health and well-being Objetiv:To analyze the perception that nursing students have about the determinants of their health status and well-being in clinical practice Methods: Exploratory research Results:The results reveal the complexity of the teaching / learning process in clinical practice, identified determinants that limit and / or promote health and well-being of students, or not contributing to their motivation, self-confidence and learning. All students value the presence of the following dimensions: affective-emotional (humanization in learning experiences); relational dynamics (interactions developed with all stakeholders); methods used (professional competence of the clinical supervisor and teacher); school curriculum (adaptation of learning in theory); socialization to the profession (become nurse).Conclusions: The results indicate, that although all students evidencing the dimensions described as fundamental to learning in clinical practice, the study results are dichotomous and ambivalent. Students 2nd and 3ºanos refer a low perception in clinical practice, the indicated dimensions, and for these source of concern and uncertainty in learning, such as limiting their health condition and well-being. For students of the 4th year, these dimensions are percecionadas as gifts, and sources of motivation, learning and catalysts such as promoting their health and well-being.